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Wednesday, 25 June 2003
Page: 12512


Senator ALLISON (3:29 PM) —I move:

That the Senate take note of the answer given by the Minister for Health and Ageing (Senator Patterson) to a question without notice asked by Senator Allison today relating to support and services for the mentally ill.

The minister quoted some programs that the government has put together, and I will not criticise any of them. However, I would argue that we have a very serious situation with regard to people with mental illnesses in this country and for that reason I cited a report prepared by the Mental Health Council of Australia. The report is entitled Out of hospital, out of mind! and was produced in April this year. I will quote from the report, because I think it is significant and should be on the record:

A nationwide review of the experiences of those who both use and provide mental health services has documented that current community based systems are failing to provide adequate services. Specifically, these services are failing in terms of restricted access, variable quality, poor continuity, lack of support for recovery from illness or protection against human rights abuses. In the view of consumers and carers and the health professionals who provide services, this does not represent a failure of policy but rather a failure of implementation through poor administration, lack of accountability, lack of ongoing government commitment to genuine reform and failure to support the degree of community development required to achieve high quality mental health care outside of institutional settings.

The minister falls back on the old familiar refrain that it is a state problem—that the states are not delivering on their promises, that the states are not putting enough money into the system. We have what is called a national mental health policy and, as this report suggests, that policy is very good one. Some very good people came together to report on it, plan it and put it together. In fact, it is leading edge stuff. It has a reputation around the world as being a very good plan. But it is not being implemented—it is being starved of resources—and the minister again falls back on the same old rhetoric of blaming it on the states. The report recommends that we:

Lift mental health expenditure to at least 12 per cent of total health expenditure—that is, an increase of just 5 per cent—within five years.

It is not saying tomorrow; it is saying that, within five years, that is where it should be. It is worth noting that, while mental disorders account for approximately 20 per cent of the burden of disease in Australia, only five per cent of the Australian health budget is spent on services for the mentally ill. I think we need to keep reminding ourselves that there may have been some extra spending over time—the minister likes to talk about the last decade and the extra $500 million—but remember that we are coming from an extremely low base. We are coming from a situation where, in the sixties, people with mental illness were pretty much put on the street and funding for them, in the community, has never recovered from that position. What else needs to be done? The report recommends:

Development of an agreement between heads of government to support and review mental health reform, and prioritising an annual reporting system on progress against agreed service improvements.

That seems straightforward to me. If you have an arrangement between the Commonwealth and the states why aren't both parties making sure that they each hold up their part of the bargain? Isn't the best way to do that to look at the objectives of your plan and see if they are actually being met? The Australian health care agreements appropriation legislation was dealt with in this place just a few days ago. I did not hear the Commonwealth government insisting that not only do they properly fund mental health but they make sure that the states do as well. It is off the agenda, because nobody is making this an embarrassing political issue for the government. It has disappeared again—still. The report recommends:

Establishment of a permanent independent commission to report on the progress of mental health reform in Australia and investigate ongoing abuse or neglect.

The Democrats have been trying to suggest for some time that this is a good idea. Let us have an independent arbiter. Let him or her wade through the rhetoric and the data and tell us whether, in fact, the states are not living up to their promises, because otherwise we do not know. The report mentions `real and sustained innovation'. It recommends:

Establishment of a national innovation system with a $100 million initial investment—

Not beyondblue or GP training, which are threepence-halfpenny worth; $100 million is needed—

and then should be supported at 5 per cent of recurrent mental health expenditure annually.

We just do not devote enough resources to this very important and demanding area. The report says:

The future costs of providing mental health care will increase substantially. This will be due to increased demand for services by, first, those who do not currently use services and, second, those who now receive grossly inadequate services. (Time expired)

Question agreed to.